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Medellín has a larger budget than ever before, but it still isn’t enough as stakeholders continue to question how money is managed in the heavily indebted city.

Only 8 months into his term as mayor of Medellín, tomato-throwing Daniel Quintero has managed to unite Paisas from labor unions to corporate giants against him.Multiple boards of directors have resigned, and Fitch has downgraded the city-owned utility's credit, citing 'governance...